Sedation w/Etomidate

[ny10570 745]

Read on another forum about a medic who couldn't even get close to sedating a very large patient with 30mg of Etomidate. To the point where the guy was still grabbing at the medic. Personally I have yet to witness or read about anything like this. I've seen the transient apnea and myoclonis, but I have yet to see someone that 0.3 mg/kg couldn't put down for a least a few minutes.

[INIT915 1,119]

Read on another forum about a medic who couldn't even get close to sedating a very large patient with 30mg of Etomidate. To the point where the guy was still grabbing at the medic. Personally I have yet to witness or read about anything like this. I've seen the transient apnea and myoclonis, but I have yet to see someone that 0.3 mg/kg couldn't put down for a least a few minutes.

Define 'large'.

If it was a 400lb patient, 30mg might have not been enough.

400lbs = 181.8kg

[WAS967 97]

My thoughts exactly. Might be time for a second hit of 30mg if the guy is still flailing about.

[Skooter92 7]

If the patient is "very large", i.e., heavier than 220lbs/100kg, than why the heck were they pushing only 30mg of Etomidate anyways? Seems the problem was with someone's math, not the drug used. Etomidate does not have any known decreased effect in the obese. There are some folks who seem to feel that "just push 30 for the big ones" is the way to go . We carry 80mg total in our catastrophic airway kit. That's plenty for most patients. I've actually had great success with giving Etomidate and then not even needing the paralytic as a chaser.

[ny10570 745]

I take back my question. Guy was well over 300lbs.